Niacin Deemed Unsafe

Niacin, the popular drug prescribed to patients with high cholesterol, was determined unsafe as a first line of treatment according to a recent clinical study.

Niacin has been recommended by doctors for decades as a safe way to lower “bad” cholesterol and raise “good” cholesterol. In fact, it is often touted as one of the oldest and safest lipid lowering drugs. Available cheaply and generically, a recent study suggests that the widespread use of the treatment may do more harm than good.

More than 25,000 people throughout Europe and China were examined in a study that showed a 32 percent increase in the rate of diabetes during the four years that the patients were studied. “There were also highly significant excesses of other recognized adverse effects of niacin, including gastrointestinal, musculoskeletal, and skin-related serious adverse events,” according to The New England Journal of Medicine report published by a team of scientists at Oxford University.

The Trouble With Niacin

Niacin, also commonly referred to as vitamin B3, is essential in maintaining healthy skin, hair, and eyes as well as the nervous and digestive systems. It also plays a key role in converting food into energy. Although most people get enough niacin from the food they eat, it is often part of multivitamins. Insufficient niacin in one’s diet can cause numerous health problems such as nausea, skin lesions, anemia, and headaches. Chronic niacin deficiency leads to a disease called pellagra, which causes a set of symptoms known as the ‘four d’s’ and includes dermatitis, diarrhea, dementia and in the worst cases- death.

Previously viewed as a safe and necessary drug, researchers are finding that excessive amounts are associated with significant risk of developing health problems. Some of the side effects include bleeding, stomach ulcers, heartburn and diarrhea. People who took niacin also had slightly more serious infections and were 9 percent more likely to die.

“On the basis of the weight of available evidence showing net clinical harm, niacin must be considered to have an unacceptable toxicity profile for the majority of patients, and it should not be used routinely,” Dr. Donald Lloyd-Jones of Northwestern University’s Feinberg School of Medicine in Chicago wrote in a commentary. “Niacin may still have a role in patients at very high risk for cardiovascular events who truly have contraindications for taking statins,” he added.

The drug is so easily available and highly regarded that curbing excessive use may pose a problem. Studies suggest the use of niacin use has more than tripled since 2002, with doctors writing an average of 700,000 prescriptions a month in the U.S. and bringing in over $800 million- not accounting for niacin purchased over the counter.

Alternatives to Niacin

Given that 71 million Americans have unhealthy cholesterol levels, there’s a huge need for cholesterol-lowering health recommendations. Complications of excess “bad” cholesterol include atherosclerosis (hardening of the arteries), peripheral artery disease, heart disease, heart attack and stroke. Although there are drug alternatives, including statins like Lipitor and Lescol, many doctors advocate long-term lifestyle changes as the main method of approaching high cholesterol. In addition to improving overall health, this appeals to many of the users of niacin who specifically chose to use the drug due to its appeal as a natural supplement.

Over time, cholesterol buildup in the arteries restricts blood flow and can lead to numerous health complications. With Niacin no longer recommended, nutrition advocated hope cardiologists will turn to diet and exercise as a main line of treatment.

The Physician’s Committee for Responsible Medicine [PCRM] points out that cholesterol is found in all foods that come from animals, including all meat and dairy products. This includes chicken and lean cuts of meat. However, no foods from plants contain cholesterol. PCRM recommends a diet based on plant foods to best address health problems. This includes an emphasis on grains, beans, vegetables, and fruits- in other words, a vegan diet. One study showed that a vegan diet allows people to achieve a significant drop in their cholesterol levels in just six weeks. Additionally, plant-based diets have been shown to reverse heart disease.

In addition to dietary recommendations, cardiologists say health can be improved by getting regular exercise and abstaining from activities that are detrimental to your health, such as smoking.